OBBBA: Helping employers make sense of what’s next

For example, analysts have predicted that federal Medicaid spending cuts are likely to result in the closure of rural hospitals, which depend heavily on Medicaid funding to operate. When access to primary care is disrupted, early prevention efforts, like regular checkups, can fall by the wayside, leading to higher downstream costs for employers in the form of unmanaged chronic conditions and avoidable ER visits.

Pulling a census file can help HR understand how much of their workforce may be impacted by such a closure. Benefits advisors can also help their HR partners identify who in their workforce may be at risk, which may pave the way for employer funding of new or expanded preventative care benefits.

Claims data can reveal hidden cost drivers

Similarly, a review of recent health care claims data can help HR spot potential opportunities for cost containment and optimized employee wellbeing. Here are a few questions advisors should consider bringing to their clients as they review data:

• Are ER visits putting their numbers over the edge? If so, what percentage of those are “avoidable” visits?
• Are employees and their dependents taking full advantage of preventive care benefits?
• Are the health plan’s preventative services effective at catching and mitigating potential complex conditions that may result in high-cost claims?

With these insights, advisors and their HR partners can collaborate on strategies for driving positive behavior changes, potentially offsetting negative OBBBA impact.

Related: The OBBBA from the executive’s viewpoint

Eligibility shifts may impact overall costs

OBBBA changes to Medicaid eligibility are another component employers need to be thinking through. Because the bill establishes an 80-hour monthly work or community engagement requirement for “able-bodied” Medicaid adults without dependents, individuals who fail to meet this threshold may lose their Medicaid coverage. Employers could feel the impact in two ways.

First, current employees who rely on Medicaid could seek to move onto the employer’s health plan, potentially increasing the organization’s overall benefits costs. Second, employers — particularly those with part-time, hourly, or seasonal roles — may see an uptick in job applications from individuals attempting to meet the 80-hour requirement to retain their Medicaid eligibility.

In both cases, reviewing workforce and group health plan (GHP) data, such as hours worked, GHP eligibility, wages, job class and current plan participation, can help model potential shifts to prepare for impacts.

Empathetic communication builds trust ahead of disruption

Another strategic approach advisors can explore with their HR partners is launching a hyper-personalized communication campaign focused on expected OBBBA impacts.

Take the earlier example of potential hospital closures. Even if those closures are months or years away, employees are navigating rumors and worries now. Proactively sharing their nearest option for primary health care is an empathetic move that builds trust and gives employees — especially those in health care deserts — time to prepare mentally and pragmatically for a change.

Early action earns loyalty

The major consequences of OBBBA will not reveal themselves for some time. Strategic thinkers, however, will not want to wait and see. They’ll want to act now to put their organizations and their employees in the best possible position for financial and physical wellness.

By looking at the data, modeling possible impacts and helping design proactive, personalized communication, benefits advisors can assist their HR partners in navigating uncertainty with confidence.

Showing up now with insight and empathy will help advisors earn lasting loyalty from the high-value employers everyone wants in their book of business.

Brooke Salazar, JD, is the senior compliance director for Businessolver's ComplianceDashboard, a platform that simplifies employee benefits compliance management for brokers, advisors and consultants.